GLOBAL STATUS REPORT ON ROAD SAFETY 2013 SUPPORTING A DECADE OF ACTION

WHO Library Cataloguing-in-Publication Data: Global status report on road safety 2013: supporting a decade of action. 1.Accidents, Traffic - statistics and numerical data. 2.Accidents, Traffic - trends. 3.Wounds and injuries - epidemiology. 4.Safety. 5.Data collection. 6.Programme evaluation. I.World Health Organization. ISBN 978 92 4 156456 4 (NLM classification: WA 275) World Health Organization 2013 All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: bookorders@who.int). Requests for permission to reproduce or translate WHO publications whether for sale or for noncommercial distribution should be addressed to WHO Press through the WHO web site (http://www.who.int/about/licensing/copyright_form/en/index.html). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Design and layout by L IV Com Sàrl, Villars-sous-Yens, Switzerland. Printed in Luxembourg. Made possible through funding from Bloomberg Philanthropies.

CONTENTS Preface.... v Acknowledgements....vi Executive summary.... vii Background.... 1 The Decade of Action for Road Safety.... 1 The purpose of this report.... 2 Methodology.... 2 Section 1. The current state of global road safety.... 3 Many countries have successfully reduced the number of deaths on their roads, while deaths are increasing in others.... 4 Middle-income countries are hardest hit.... 4 The African Region has the highest road traffic fatality rate.... 5 Half of all road traffic deaths are among pedestrians, cyclists and motorcyclists.... 6 Almost 60% of road traffic deaths are among 15 44 year olds.... 7 Non-fatal crash injuries are poorly documented.... 7 Harmonizing data collection on road traffic deaths... 8 Section 2. New road safety laws: progress to date.... 11 Reducing speed.... 13 Progress to reduce excessive speed has stalled.... 13 Reducing urban speeds protects pedestrians and cyclists.... 14 Speed limits need stronger enforcement.... 15 Reducing drinking and driving.... 16 Drink drive laws should be based on blood alcohol concentration levels.... 16 Strong drink drive laws protect almost 70% of world s population.... 16 More stringent drink drive laws for high-risk drivers.... 16 Drink drive laws need stronger enforcement.... 16 Almost half of all countries lack of data on alcohol-related road traffic deaths.... 17 Increasing motorcycle helmet use.... 18 Head injuries among motorcyclists are a growing concern.... 18 More effort is needed to promote helmet standards and quality.... 18 Data on helmet use is weak.... 20

Increasing seat-belt use.... 22 Progress has been made in tightening up seat-belt laws.... 22 Enforcing seat-belt laws needs more emphasis.... 23 Only half of countries collect seat-belt wearing data.... 23 Increasing the use of child restraints.... 25 More countries need to adopt child restraint use.... 25 Encouraging child restraint use.... 26 Lead agencies are vital to developing a national road safety strategy.... 27 Involving multiple sectors in national road safety efforts is critical.... 27 National road safety strategies should include targets to minimize injuries, deaths and key risk factors.... 27 Section 3. Transport policies neglect pedestrians and cyclists.... 29 Governments need to make walking and cycling safe.... 30 Safer roads reduce crash likelihood and severity.... 32 Action is needed to make vehicles safer for non-car road users.... 33 Public transport can make mobility safer and reduce congestion.... 33 Conclusions and recommendations.... 37 References.... 39 Explanatory notes.... 41 Methodology, data collection and validation.... 42 Country profile explanations.... 45 Estimating global road traffic deaths.... 48 Country Profiles.... 53 Statistical Annex.... 237

Preface Progress is being made to make the world s roads safer, but this critical work must be intensified and accelerated. In 2010 the governments of the world declared 2011 2020 as the Decade of Action for Road Safety. They invited the World Health Organization to prepare this report as a baseline to assess the state of global road safety at the onset of the Decade, and to be able to monitor progress over the period of the Decade. The unanimous support for this Decade of Action from Member States indicates a growing awareness that the devastating scale of road traffic injuries is a global public health and development concern. This report shows that 1.24 million people were killed on the world s roads in 2010. This is unacceptably high. Road traffic injuries take an enormous toll on individuals and communities as well as on national economies. Middle-income countries, which are motorizing rapidly, are the hardest hit. There is a sound body of scientific evidence behind road safety interventions. Adopting and enforcing legislation relating to important risk factors speed, drink driving, motorcycle helmets, seat-belts and child restraints has been shown to lead to reductions in road traffic injuries. This report illustrates some of the progress made in a number of countries to address these risk factors since publication of the first Global status report on road safety (2009). Since 2008, 35 countries have passed new laws or amended existing legislation covering one or more of these risk factors. Nevertheless, in many countries these laws are either not comprehensive in scope or are lacking altogether. Governments must do more to ensure that their national road safety laws meet best practice, and do more to enforce these laws. Road safety was recognized in global environmental policy deliberations at the recent Rio+20 UN Conference on Sustainable Development. A clear link was made between road safety and sustainable development. Encouraging sustainable transport policy must include making non-motorized forms of transport accessible and safe: this report shows that 27% of global road traffic deaths are among pedestrians and cyclists. To date, these road users have been neglected in transport and planning policy. The world must now increase its focus on making walking and cycling safer, and protecting these road users from high-speed traffic. The benefits of such a move will be far greater than purely the health benefits of reduced road traffic injuries. Benefits will include reduced air pollution and greenhouse gas emissions, reductions in traffic congestion, and the health outcomes that come from increased physical activity. This report shows that, with sufficient political will, road traffic deaths can be averted. In supporting the Decade of Action for Road Safety, governments around the world have shown their political commitment to make the world s roads safer. The Decade offers a unique platform upon which to address this issue. The challenge is to keep this pledge and enhance the pace of change. Only then can the goal of the Decade of Action for Road Safety be met. Dr Margaret Chan Director-General World Health Organization SUPPORTING A DECADE OF ACTION v

Acknowledgements The Global status report on road safety 2013 benefited from the contributions of a number of WHO staff: Tami Toroyan coordinated and wrote the report, with data management and statistical analysis conducted by Kacem Iaych; Margie Peden provided strategic and technical oversight; data collection was facilitated by WHO Representatives and staff at country level; at regional level, trainings, data collection and validation were carried out by: Martial Missimikim and Martin Ekeke Monono (Africa); Astrid Arca, Alessandra Senisse Pajares and Eugênia Rodrigues (the Americas); Rania Saad, Hala Sakr and Hala Youssef (Eastern Mediterranean); Francesco Mitis and Dinesh Sethi (Europe); Rania Saad and Chamaiparn Santikarn (South-East Asia); and Krishnan Rajam, Mayet Darang and Xiangdong Wang (Western Pacific). Other WHO staff who contributed to the development and production of the report include Ala Alwan, Nicholas Banatvala, Oleg Chestnov, Manjul Joshipura, Doris Ma Fat, Evelyn Murphy, Etienne Krug, Jon Passmore, Pascale Lanvers-Casasola, Colin Mathers, Florence Rusciano and Jelica Vesic. Country level data could not have been obtained without the invaluable input of: the National Data Coordinators (see Table A1 in the Statistical Annex); all respondents and attendees of the consensus meetings in countries; government officials who provided clearance of the information for inclusion in the Report. WHO also wishes to thank the following contributors whose expertise made this document possible: Jennifer Ellis, Kelly Henning and Kelly Larson from Bloomberg Philanthropies; Adnan Hyder, Olive Kobusingye, Junaid Razzak and David Ward, who provided expert advice and review comments; Claudia Adriazola-Steil, Abdulgafoor Bachani, Madhav Pai, Nagi Shafik, David Ward, Esti Widiastuti, Gde Yogadhita for providing information for boxes; Alison Harvey for preparing and checking country profiles; Angela Burton who edited and proofread the report; Drew Blakeman for valuable editorial input; Graphic designers from L IV Com Sàrl who produced the design and layout. Finally the World Health Organization wishes to thank Bloomberg Philanthropies for its generous financial support for the development and publication of this report. GLOBAL STATUS REPORT ON ROAD SAFETY, 2013 vi